Assessment of resident training in laparoscopic surgery based on a digestive system anastomosis model in the laboratory

The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a laboratory training program. Prospective study of surgical...

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Veröffentlicht in:Cirugia Española 2010-01, Vol.87 (1), p.20-25
Hauptverfasser: Rodríguez-Sanjuán, Juan Carlos, Manuel-Palazuelos, Carlos, Fernández-Díez, María José, Gutiérrez-Cabezas, José Manuel, Alonso-Martín, Joaquín, Redondo-Figuero, Carlos, Herrera-Noreña, Luis Antonio, Gómez-Fleitas, Manuel
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container_end_page 25
container_issue 1
container_start_page 20
container_title Cirugia Española
container_volume 87
creator Rodríguez-Sanjuán, Juan Carlos
Manuel-Palazuelos, Carlos
Fernández-Díez, María José
Gutiérrez-Cabezas, José Manuel
Alonso-Martín, Joaquín
Redondo-Figuero, Carlos
Herrera-Noreña, Luis Antonio
Gómez-Fleitas, Manuel
description The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a laboratory training program. Prospective study of surgical resident training based on anastomosis performance on an "endotrainer". The program consisted of 4 weeks per year (20h per week) between 2004 and 2007. The outcome measures were the time and number of anastomosis necessary to perform a proper anastomosis. Upon completion, the anastomosis was checked by both trainee and evaluator and quality was assessed. Time and technical failures (loose suture, edge eversion, leakage) were recorded. Twelve surgical residents were trained. They performed 189 jejuno-jejunal anastomoses (JJA), mean 15.8 per resident and 197 gastro-jejunal anastomoses (GJA), mean 16.4 per resident. The performance mean time was 72.7 min for JJA and 87.2 for GJA. There was a marked reduction in time from the beginning to completion of training. The percentage of flawed anastomosis decreased with training: 26.6%, 21.8%, 17.1%, 17%, 16.1% and 10.5% after 20, 40, 60, 80, 100 and 120 h, respectively. Bearing in mind reduction in both performance time and flawed anastomosis rate, it appears that after 70 h of training the learning curve reaches a plateau zone. Intestinal anastomosis (either JJA or GJA) performed in "endotrainer" is a suitable model for laparoscopic training, without the need of live animals. After a training period of 70 hours, the improvement seems of little benefit.
doi_str_mv 10.1016/j.ciresp.2009.08.003
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subjects Anastomosis, Surgical - education
Internship and Residency
Jejunum - surgery
Laparoscopy
Models, Anatomic
Prospective Studies
Stomach - surgery
title Assessment of resident training in laparoscopic surgery based on a digestive system anastomosis model in the laboratory
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